Experience in the treatment of liver echinococcosis in Grodno Region, Belarus

Background: A parasitic hydatid disease called liver echinococcosis is brought on by the tapeworm echinococcus and is a reason for concern for global health. In addition to the liver, the lungs can harbor parasites. In the life cycle of parasites, humans occupy a middle position. Depending on the size and intensity of the cyst, the clinical signs can vary and be non-specific. The complications include bleeding, perforation, suppuration, cyst rupture, mechanical jaundice, and portal hypertension. Here is an analysis of own results of surgical treatment of patients with liver echinococcosis in Grodno region, Belarus between June 2012 to October 2022. Methods: The research design was cross-sectional. Diagnostic methods that are instrumental and laboratory-based include a general blood test, a biochemical blood test, an enzyme immunoassay (IFA), abdominal and retroperitoneal MRIs and ultrasounds, abdominal and chest CT scans and brain scans. There were 10 men and 17 women among the 27 patients. The age range of the majority of the patients was 18 to 83. Results: All patients underwent resections, including laparoscopic procedures. One of the patients in our series of cases received a two-stage therapy regimen due to a secondary focus of echinococcosis in the left lung. In our series of cases, no postoperative complications or mortality occurred. Conclusions: Patients with hepatic echinococcosis should be treated at specialized hospitals. Abdominal, chest, and brain CT scans are required in order to search for additional foci. When it comes to treating echinococcosis, minimal invasive surgical procedures should be preferred.

The universal immunization programme coverage and determining factors among tribal children under the age of five in the Wayanad district of Kerala, South India

Background: Globally an estimated two to three million deaths occur every year in all age groups, from six major vaccine-preventable diseases and accounts for almost a quarter of all deaths in children under the age of five years. As Immunization is one of the most successful and cost-effective methods for preventing infectious diseases, the Indian government initiated a vaccination programme to reduce infant mortality and morbidity owing to vaccine-preventable diseases, and achieve vaccine self-sufficiency. In Kerala, about 1.5% of the total population makes up Scheduled Tribes, a socioeconomic group with continuously poor health indicators. Methods: Through a community-based cross-sectional study using cluster sampling technique, this study intends to determine the coverage of the universal immunization programme among tribal children (0-59 months), the factors affecting vaccination coverage as well as the reasons for partial immunization in Noolpuzha Panchayat, Wayanad. A semi-structured questionnaire was used to collect information from caregivers/mothers. Results: Out of 289 study population, 64.4% were fully immunized and 35.6% were partially immunized. Children's age and the father's education were found to affect immunization. Conclusions: As a lack of knowledge about immunizations and subsequent doses was the primary reason for partial immunization. There is a need to create awareness about the importance of vaccination and the subsequent doses among the tribal people of Wayanad.

Ventilator associated pneumonia: unravelling prevalence risk factor and antibiotic usage

Background: Hospital acquired infections, are a leading cause of mortality and morbidity. Ventilator associated pneumonia, one of the hospital acquired illnesses. The purpose of this study was to evaluate the prevalence, risk factors, causative organism, and antibiotic usage for the treatment of ventilator-associated pneumonia. Methods: Between May 2022 and October 2022, 50 patients participated in an ambispective and observational study conducted across several ICU departments at Adichunchanagiri Hospital, BG Nagara, Karnataka. Reviewing and evaluating daily patient case sheets, laboratory results, and treatment charts of participants who were hospital inpatients provided pertinent data needed for the study. Volunteers were enrolled after taking consent from each of them, a suitably designed data collection form was used to collect all the necessary information. Microsoft Excel was used to enter the data. Version 28 of SPSS was used to analyze the data. Statistical significance was determined by using a P-value of less than 0.05. Results: The study included 50 patients and discovered a 60% prevalence of ventilator-associated pneumonia in the general community. Staphylococcus aureus accounted for 26.7% of all gram-positive bacteria, whereas Enterobacter and Klebsiella species accounted for 16.7%. Metronidazole was given in 64% of instances, with accidents being the most frequent risk factor (40%). Conclusions: Within the specified population, the incidence of ventilator-associated pneumonia is 60%, with Staphylococcus aureus identified as the most predominant bacterial pathogen. Metronidazole is the most frequently prescribed antibiotic, and accidents are the key risk factors that cause ventilator-associated pneumonia.

Prevalence, risk factors, causative organism and antibiotic susceptibility of catheter associated urinary tract infections

Background: The most common nosocomial infection is catheter-associated urinary tract infection (CAUTI), with a 3-7% daily risk of developing CAUTI in acute care settings. This study's goal was to identify the prevalence, risk factors, causative organism of CAUTI and understanding the organism's current antimicrobial agent sensitivity profile. Methods: Total 120 patients participated in a prospective and observational study conducted at Adichunchanagiri Hospital, Karnataka. Reviewing and evaluating patient case sheets, laboratory results, and treatment charts of participants who were hospital inpatients provided data needed for the study. Microsoft Excel was used to enter the data and version 28 of SPSS to analyze the data. Statistical significance was determined by using a P-value of less than 0.05. Results: It was discovered that 12.5% of HAI cases were linked to catheter use. The most prevalent microbial agent in the current investigation was E. coli (41.7%). According to the current study, women are more likely than men to get UTIs. An underlying medical condition was found to have a strong correlation with UTIs in the current investigation. For CAUTI, drug resistance to cefotaxime and tigecycline was noted. Conclusions: The study suggested that gender, age extremes, use of antibiotics, length of stay in intensive care unit, diabetes mellitus, immunosuppressive medication, and indwelling urinary devices are the major risk factors for CAUTI. E. coli was the most common microbiological agent in the current study. Therefore, to assist doctors in the treatment and management of CAUTIs, ongoing surveillance of antimicrobial resistance patterns is required.

India’s sustaining challenges to combat rabies elimination: a comprehensive review

Rabies is one of the fatal zoonotic diseases wreaking havoc on humanity since antiquity. India continues to suffer the greatest rabies burden of any country, both in terms of annual human deaths and disability-adjusted life years. While modern rabies management emphasizes the importance of achieving zoonotic disease control and prevention through a One Health approach, the disease remains challenging as its persistence is invariably multifaceted. Therefore, it is imperative to examine the enduring reasons for the increasing incidence of rabies in India. Between 2012- 2022, a systematic search of scientific publications, popular search engines like Google, as well as in the grey literature regarding rabies was carried out. Since rabies elimination boils down to addressing the reasons, it is first seen related to the large and unvaccinated stray dog population, where 97% of cases are by dog bites. A second finding is that many bite victims resorted to indigenous treatment practices due to insufficient awareness and knowledge about the disease. Incomplete treatment practices also led to some deaths, especially because rabies vaccines are not affordable or accessible to poverty-stricken populations. Rarely, vaccine failures were caused by a lack of vaccine potency, a wound type, or ineffective administration methods. Even with all these data incorporated, there was no information on prevalence/incidence estimates of dog bites in recent years through national data. Therefore, without intensified surveillance, sustained political commitment, enormous mobilization of resources, and rabies education, the epidemic waves of this fatal disease will continue in India.

Diagnosis of cervical lesion by colposcopy, VIA, pap smear tests, and their correlation with histopathology in a tertiary level laboratory in Chattogram, Bangladesh

Background: Cervical carcinoma is one of the most common causes of mortality among women. This mortality rate can be reduced by early detection of cervical neoplasm by different screening tests. The main objective of this study was to diagnose cervical diseases by colposcopy, by pap smears for cytological examination as well as correlate these findings as screening tests with histopathological diagnosis. Methods: In this cross-sectional observational study, total 143 cases were included. History was taken and clinical examination was done. Colposcopy and VIA test was done, pap smear sample was collected and reporting was made. Cytological findings were correlated with histopathology. Results: Mean age of the study cases was 41.2±11.5 years. VIA test was positive in 98 study cases (68.5%). On colposcopy, most of the cases show neoplastic proliferation (80 cases, 55.9%). Among them, most cases were diagnosed as cervical intraepithelial neoplasia-I (CIN-I). Sixty-three (63) cases (44.1%) were non-neoplastic. Most of the biopsies was diagnosed histopathologically as cervical intraepithelial neoplasia-I (CIN-I) (20 cases, 14.0%). Association of colposcopy findings with histopathological diagnosis was done which was significant. Sensitivity of diagnosis of cervical malignancy by colposcopy was 33.33% and specificity was 98.57%. Conclusions: The study provides good cyto-histopathology correlation in detecting different cervical lesions and malignancy with colposcopy. Although colposcopy sensitivity was low but it can be increased by adequate training and avoiding technical errors. Bethesda system is strongly recommended for adequacy of sampling to minimize inconsistency. Early and regular screening should be advised for reduction of mortality rates from cervical carcinoma.

New Therapeutic Perspective Based on Anacardium humile in the Treatment of Skin Wound Infected by Staphylococcus aureus

This is a literature review with the objective of presenting scientific evidence about the therapeutic importance of the use of Anacardium humile for the treatment of infected skin wounds. Retrospective and analytical study carried out from 1999 to 2021, in the Bireme, UpToDate, Pubmed and Scielo databases. The association of the descriptors “Phytotherapy” was used; “Cerrado and Pantanal Plants”; “Wounds contaminated by bacteria”; “elastic fibers”. Of the 248 articles analyzed, 36 were included in the review because they met the inclusion criteria. Among the results, it was evidenced that the conventional treatments, although effective (the gold standard being Sulfadiazine 1% silver), present toxicity to human keratinocytes and fibroblasts, with this, it is concluded that further research will be necessary to prove the effectiveness of new treatment options or association of herbal medicines with treatment.

Biological behavior of magnesium-substituted hydroxyapatite during bone repair / Comportamento biológico de hidroxiapatita substituída com magnésio durante o reparo ósseo

Abstract The aim of this study was to analyze the biological behavior and osteogenic potential of magnesium (Mg) substituted hydroxyapatite (HA) microspheres, implanted in a critical bone defect, considering that this ion is of great clinical interest, since it is closely associated with homeostasis and bone mineralization. For the purpose of this study, 30 rats were used to compose three experimental groups: GI - bone defect filled with HA microspheres; GII - bone defect filled with HA microspheres replaced with Mg; GIII - empty bone defect; evaluated at biological points of 15 and 45 days. The histological results, at 15 days, showed, in all the groups, a discrete chronic inflammatory infiltrate; biomaterials intact and surrounded by connective tissue; and bone neoformation restricted to the borders. At 45 days, in the GI and GII groups, an inflammatory response of discrete granulomatous chronic type was observed, and in the GIII there was a scarce presence of mononuclear inflammatory cells; in GI and GII, the microspheres were seen to be either intact or fragmented, surrounded by fibrous connective tissue rich in blood vessels; and discrete bone neoformation near the edges and surrounding some microspheres. In GIII, the mineralization was limited to the borders and the remaining area was filled by fibrous connective tissue. It was concluded that the biomaterials were biocompatible and osteoconductive, and the percentage of Mg used as replacement ion in the HA did not favor a greater bone neoformation in relation to the HA without the metal.

Resumo O objetivo deste estudo foi analisar o comportamento biológico de microesferas de hidroxiapatita (HA) substituída com magnésio (Mg) durante o reparo de defeito ósseo crítico, tendo em vista que este íon é de grande interesse clínico, pois está intimamente associado à homeostasia e à mineralização óssea. Para tanto, utilizou-se 30 ratos para compor três grupos experimentais: GI - defeito ósseo preenchido com microesferas de HA; GII - defeito ósseo preenchido com microesferas de HA substituída com Mg; GIII (controle) - defeito ósseo vazio; avaliados nos pontos biológicos de 15 e 45 dias. Os resultados histológicos evidenciaram, aos 15 dias, discreto infiltrado inflamatório crônico e neoformação óssea restrita às bordas, em todos os grupos. Nos grupos GI e GII, os biomateriais mantiveram-se íntegros e circundados por tecido conjuntivo frouxo. Aos 45 dias, notou-se resposta inflamatória do tipo crônica granulomatosa discreta nos grupos GI e GII, e no GIII presença escassa de células inflamatórias mononucleares. As microesferas implantadas no GI e GII mantiveram-se, em sua maioria, íntegras e envolvidas por tecido conjuntivo fibroso. Notou-se discreta neoformação óssea próxima às bordas e circunjacente a algumas microesferas. No GIII, a mineralização limitou-se às bordas e a área remanescente foi preenchida por tecido conjuntivo fibroso. Conclui-se que os biomateriais foram biocompatíveis, bioativos, osteocondutores e apresentaram biodegradação lenta, indicando seu grande potencial para em aplicações clínica como biomaterial de preenchimento.

Biological behavior of magnesium-substituted hydroxyapatite during bone repair

Abstract The aim of this study was to analyze the biological behavior and osteogenic potential of magnesium (Mg) substituted hydroxyapatite (HA) microspheres, implanted in a critical bone defect, considering that this ion is of great clinical interest, since it is closely associated with homeostasis and bone mineralization. For the purpose of this study, 30 rats were used to compose three experimental groups: GI - bone defect filled with HA microspheres; GII - bone defect filled with HA microspheres replaced with Mg; GIII - empty bone defect; evaluated at biological points of 15 and 45 days. The histological results, at 15 days, showed, in all the groups, a discrete chronic inflammatory infiltrate; biomaterials intact and surrounded by connective tissue; and bone neoformation restricted to the borders. At 45 days, in the GI and GII groups, an inflammatory response of discrete granulomatous chronic type was observed, and in the GIII there was a scarce presence of mononuclear inflammatory cells; in GI and GII, the microspheres were seen to be either intact or fragmented, surrounded by fibrous connective tissue rich in blood vessels; and discrete bone neoformation near the edges and surrounding some microspheres. In GIII, the mineralization was limited to the borders and the remaining area was filled by fibrous connective tissue. It was concluded that the biomaterials were biocompatible and osteoconductive, and the percentage of Mg used as replacement ion in the HA did not favor a greater bone neoformation in relation to the HA without the metal.

Resumo O objetivo deste estudo foi analisar o comportamento biológico de microesferas de hidroxiapatita (HA) substituída com magnésio (Mg) durante o reparo de defeito ósseo crítico, tendo em vista que este íon é de grande interesse clínico, pois está intimamente associado à homeostasia e à mineralização óssea. Para tanto, utilizou-se 30 ratos para compor três grupos experimentais: GI - defeito ósseo preenchido com microesferas de HA; GII - defeito ósseo preenchido com microesferas de HA substituída com Mg; GIII (controle) - defeito ósseo vazio; avaliados nos pontos biológicos de 15 e 45 dias. Os resultados histológicos evidenciaram, aos 15 dias, discreto infiltrado inflamatório crônico e neoformação óssea restrita às bordas, em todos os grupos. Nos grupos GI e GII, os biomateriais mantiveram-se íntegros e circundados por tecido conjuntivo frouxo. Aos 45 dias, notou-se resposta inflamatória do tipo crônica granulomatosa discreta nos grupos GI e GII, e no GIII presença escassa de células inflamatórias mononucleares. As microesferas implantadas no GI e GII mantiveram-se, em sua maioria, íntegras e envolvidas por tecido conjuntivo fibroso. Notou-se discreta neoformação óssea próxima às bordas e circunjacente a algumas microesferas. No GIII, a mineralização limitou-se às bordas e a área remanescente foi preenchida por tecido conjuntivo fibroso. Conclui-se que os biomateriais foram biocompatíveis, bioativos, osteocondutores e apresentaram biodegradação lenta, indicando seu grande potencial para em aplicações clínica como biomaterial de preenchimento.

Desenvolvimento de bezerros leiteiros alimentados com silagem de leite de transição: I - Trato digestivo / Development of dairy calves fed silage transition milk: I - Digestive tract

Avaliou-se o desenvolvimento do trato digestivo de bezerros Holandeses aleitados com silagem de leite de transição. Foram utilizados 18 animais, com peso corporal inicial médio de 36,50kg (±4,03), alimentados individualmente em baias com concentrado, feno de Cynodon sp., água e suplemento mineral oferecidos ad libitum. O delineamento experimental foi inteiramente ao acaso, com três tratamentos e seis repetições. Os tratamentos consistiram em leite integral e silagem de leite de transição diluída em água ou misturada em leite, correspondendo a quatro litros diários divididos em duas refeições, durante 59 dias. Aos 60 dias, os bezerros foram abatidos e realizaram-se pesagens do trato digestivo e medidas histológicas das papilas ruminais. O sistema de aleitamento não interferiu nos consumos de concentrado e matéria seca total e no desenvolvimento de papilas ruminais (P>0,05). A silagem de leite de transição diluída em água resultou em menor peso corporal, menor peso corporal vazio e absoluto do abomaso e maior desenvolvimento intestinal. O aleitamento com silagem misturada em leite não comprometeu o desenvolvimento corporal e do trato digestivo até 60 dias de idade, representando alternativa ao aleitamento com leite...

This study aimed to evaluate the development of the digestive tract of Holstein calves which suckled milk from silage transition. We used 18 animals, with an average initial body weight of 36.50kg (±4.03), individually housed in pens with concentrate, hay Cynodon sp., water and mineral supplement offered ad libitum. The experimental design was completely randomized with three treatments and six replications. Treatments consisted of whole milk and silage transitional milk, diluted with water or mixed with milk, corresponding to four liters per day divided over two meals during 59 days. The food intake was monitored daily and weighed every week after the supply of liquid diet in the morning. At 60 days, the calves were slaughtered and the digestive tract was weighed and histological measures of rumen papillae were taken. The nursing system did not affect the consumption of concentrate and total dry matter and the development of rumen papillae (P>0.05). The silage transition milk diluted in water resulted in lower final body weight, lower body weight and absolute emptiness abomasum and intestinal further development. Milk transition silage mixed in milk did not affect the development of the digestive tract and body until 60 days of age, representing an alternative to milk...

Effect of stabilization exercise on lumbar multifidus muscle thickness in patients with non-specific chronic low back pain

In a single blinded randomized controlled study, we investigated the effect of stabilization exercise on lumbar multifidus muscle thickness in patients with non-specific chronic low back pain. Low Back Pain is highly prevalent and results in considerable level of disability. Many causes have been associated with weakness or injury of the soft tissues in the lumbar area. A total of 122 individuals [44 males, 78 females] with non-specific chronic low back pain participated in this study. They were assigned to four different groups. Group 1 received stabilization exercise only. In addition to stabilization exercise, groups 2 and 3 received Transcutaneous Electrical Nerve Stimulation and massage therapy respectively and group 4 was the control group who received drug therapy only. Participants went through this protocol twice weekly for 8 consecutive weeks. Measurement of muscle thickness using Ultrasound scanning machine was done at baseline and end of 8[th] week. Analysis of variance was used to determine significant difference at p < 0.05. There was an increase in the Lumbar Multifidus muscle thickness at L4-L5 lumbar vertebra post-intervention assessment with more increment in group 2 with a mean and standard deviation of 3.28 +/- 0.47, within the three groups except the control. The study established that stabilization exercise alone and in combination with Transcutaneous Electrical Nerve Stimulation and massage is effective in increasing the thickness of Lumbar Multifidus muscle in patients with non-specific chronic low back pain

Cardiovascular and respiratory alterations in dogs during cervical myelography using ioversol / Alterações cardiovasculares e respiratórias durante a mielografia cervical com ioversol em cães

Subarachnoid infusion of most contrast mediums and the steps involved in performing a cervical myelography have adverse affects that can discourage its use in the radiographic diagnosis of spinal cord diseases. Thus, the cardiovascular and respiratory alterations associated with neck flexion, subarachnoid puncture, and cerebrospinal fluid drainage during subarachnoid infusion of ioversol (320mgI/mL) in dogs under general anesthesia using isoflurane were evaluated. The dogs received subarachnoid infusion of autologous cerebrospinal fluid kept at 38°C - control group (GC); ioversol 0.3mL/kg at 25°C (GI25) and ioversol 0.3mL/kg heated to 38°C (GI38). Each dog had its heart rate (HR), systolic arterial pressure (SAP), diastolic arterial pressure (DAP), respiratory rate (RR), oxyhemoglobin saturation (SaO2) and electrocardiography readings (PR and QT intervals) recorded. Group comparisons showed no statistical difference regarding neck positioning, subarachnoid puncture, and subarachnoid infusion of contrast medium on HR, RR and SaO2, cardiac rhythm or conduction. However, isoflurane significantly increased PR and QT intervals. Based on these findings, it is concluded that the steps involved in cervical myelography and the use of ioversol 320mgI/mL at 0.3mL/kg (25ºC and 38ºC) during cervical myelography did not result in relevant cardiovascular and respiratory alterations, except for an elevation in arterial pressure after injection of ioversol.

Os efeitos adversos provocados pela infusão subaracnoidea de meios de contraste e da mielografia cervical podem desencorajar sua aplicação como alternativa para o diagnóstico radiológico de doenças da medula espinhal. Assim, avaliaram-se os efeitos cardiovascular e respiratório dos procedimentos técnicos necessários à mielografia cervical e da infusão subaracnoidea do ioversol - 320mgI/mL - em cães anestesiados com isofluorano. Foi realizada infusão do líquido cefalorraquidiano autólogo mantido a 38°C - grupo-controle (GC); infusão do ioversol 0,3mL/kg a 25°C (GI25); e infusão do ioversol 0,3mL/kg aquecido a 38°C (GI38). Estudaram-se: pressões arteriais sistólica (PAS) e diastólica (PAD), frequências cardíaca (FC) e respiratória (FR), saturação de oxi-hemoglobina (SaO2) e medidas eletrocardiográficas (intervalos PR e QT). Não houve influência significativa do posicionamento, da punção ou da infusão subaracnoidea do ioversol sobre FC, FR, SaO2, ritmo e condução cardíaca, entretanto o isofluorano aumentou significativamente os intervalos PR e QT. Concluiu-se que a mielografia cervical com ioversol 320mgI/mL, nas temperaturas de 25ºC e 38ºC e na dose de 0,3mL/kg, não causa arritmias cardíacas nem alterações cardiovasculares e respiratórias relevantes, exceto elevação da pressão arterial após a injeção do contraste.

Perfil da prescrição e dispensação de antibióticos para crianças em uma Unidade Básica de Saúde (UBS) no município de Ijuí-RS / Prescription profile and dispensing of antibiotics for children in a Primary Health Center in the city ofIjuí (RS, Brazil)

Os hábitos prescritivos e o processo de dispensação de medicamentos são determinantes para o uso racional de antibióticos. Com o objetivo de descrever o perfil de prescrição e dispensação de antibióticos usados por crianças, foram analisadas 100 prescrições pediátricas que continham antibióticos aviadas em uma Unidade Básica de Saúde do município de Ijuí/RS de abril a dezembro de 2009. Observou-se prevalência de meninas (53%) com idades entre quatro e seis anos (39%) e que receberam prescrição de azitromicina (45%) e amoxicilina (40%). Verificou-se em média 3,5±8,71 medicamentos por prescrição devido à associação de analgésicos, anti-inflamatórios, antitérmicos e antialérgicos aos antibióticos prescritos. Nenhuma prescrição apresentou todos os itens avaliados: o endereço do usuário e advertências sobre o uso dos medicamentos prescritos não foram encontrados nas prescrições analisadas e apenas 5% estavam legíveis. Já posologia, denominação genérica, nome completo do usuário e dados do prescritor foram verificados em todas as prescrições. Sugere-se a qualificação das equipes de saúde a fim de atuarem nos processos de prescrição e dispensação de medicamentos e implantarem ações educativas sobre uso, guarda e descarte de antibióticos junto aos usuários. O acompanhamento farmacoterapêutico pode ser uma estratégia efetiva para prevenir resistência microbiana e reações adversas a antibióticos.

Prescribing habits and the process of dispensing medicines are determining factors for the rational use of antibiotics. With the objective of describing the profile of antibiotic prescription and dispensing for children, 100 pediatric prescriptions containing antibiotics, issued at a district Primary Health Center in the city of Ijuí, from April to December 2009, were analysed. There was a prevalence of girls (53%), aged between four and six years (39%), who were prescribed azithromycin (45%) and amoxicillin (40%). The mean number of medicines per prescription was 3.5±8.71, owing to the combination of analgesic, anti-inflammatory, antipyretic and anti-allergy drugs with the antibiotics prescribed. Not one prescription included all the items assessed: the patient?s address and warnings about the use of prescribed medications were not found in the prescriptions analyzed and only 5% were legible. On the other hand, dosage, generic name, full name of the user and the prescriber data were found in all prescriptions. It is suggested that health teams be qualified to work in the processes of prescription and dispensing of medicines and to conduct educational activities on the use, storage and disposal of antibiotics among the users. Pharmacotherapeutic follow-up can be an effective strategy to prevent bacterial resistance and adverse reactions to antibiotics.

Digestibilidade aparente dos nutrientes de dietas simplificadas baseadas em forragens para coelhos em crescimento / Apparent digestibility of nutrients of simplified diets based on forages for growing rabbits

Avaliaram-se os efeitos de dietas simplificadas à base de forragens sobre a digestibilidade aparente dos nutrientes em coelhos Nova Zelândia branco. As dietas experimentais foram: referência (REF), feno de alfafa (FAL), feno das folhas de rami (FRA), feno das folhas de amoreira (FAM) e feno do terço superior da rama da mandioca (FMA). A digestibilidade das dietas foi influenciada pelo tipo de alimento estudado; a FMA apresentou coeficientes de digestibilidade inferiores às demais dietas para todos os princípios nutritivos analisados. Para a dieta FAM, os coeficientes de digestibilidade aparente dos princípios nutritivos foram maiores (P<0,05) que os coeficientes das outras dietas estudadas. Os animais que ingeriram a dieta FAM apresentaram distúrbios digestivos e baixos consumos, com efeito negativo sobre os resultados. Os coeficientes de digestibilidade aparente das demais dietas estudadas foram semelhantes (P>0,05). Os valores estimados de energia digestível (kcal ED/kg MS) e proteína digestível ( por centoPD/MS) foram, respectivamente, para o feno de alfafa: 2285,27 e 16,04; feno das folhas de rami: 1857,88 e 16,37; feno das folhas de amoreira: 2838,48 e 15,12 e feno do terço superior da mandioca: 2155,55 e 10,57.

The effect of simplified diets based on forages on the apparent digestibility in white New Zealand rabbits was evaluated. The treatments were based on the following diets: reference (REF), hay of alfalfa (FAL), hay of rami leaves (FRA), hay of mulberry leaves (FAM) and hay of upper to 1/3 aereal part of cassava (FMA). The type of food affected the digestibility of the diets. The FMA diet showed low coefficients of digestibility in comparison to the other diets for all the analyzed nutrients. For the FAM diet the coefficients of apparent digestibility of the nutrients had higher values (P<0.05) than the coefficients of the other studied diets. The animals that ingested FAM diet showed digestive disorders and low consumption, with negative effect on the results. The coefficients of apparent digestibility of the remaining diets were similar (P>0.05). The estimated values of digestible energy (kcal DE/kg DM) and digestible protein ( percentDP/DM) were, respectively, 2285.27 and 16.04 for alfalfa hay, 1857.88 and 16.37 for hay of rami leaves, 2838.48 and 15.12 for hay of mulberry leaves and 2155.55 and 10.57 for hay of upper to 1/3 aereal part of cassava.

What do medical students in Alexandria know about female genital mutilation?

We explored the knowledge, beliefs and attitudes of 330 5th year medical students in Alexandria University towards female genital mutilation [FGM]. The students' basic knowledge about the practice of FGM was unsatisfactory. Students were unaware of the prevalence of FGM in Egypt and the practices and procedures of FGM. They were also poorly informed about the complications of FGM, and the ethical and legal aspects of FGM in the country. As a result, 52.0% of the students supported the continuation of the practice and 73.2% were in favour of its "medicalization" as a strategy for reducing the risks of FGM. Most students [86.9%] thought that the issue of FGM should be incorporated into the undergraduate medical curriculum

Rapid molecular diagnosis of tuberculosis and other mycobacteriosis in smear-negative clinical specimens

Delay in diagnosis of pulmonary and other forms of tuberculosis (TB) can be fatal, particularly in HIV-infected patients. Hence, techniques based on nucleic acid amplification, which are both rapid and of high specificity and sensitivity, are now widely used and recommended for laboratories that diagnose TB. In the present study, diagnostic methods based on mycobacterial DNA amplification were evaluated in comparative trials alongside tradicional bacterial methods, using negative smear samples from patients with clinically-suspected TB (sputum samples from 25 patients with suspected pulmonary TB, urine samples from two patients with suspected renal TB and cerebrospinal fluid samples from one patient with suspected meningeal TB). A specificity of 100% was achieved with DNA amplification methods and tradicional culture/identification methods, in relation to clinical findings and treatment results. For the smear-negative sputa, conventional PCR for M.tuberculosis was positive in 62% of suspected lung TB case, showing the same sensitivity as bacterial identification. Both techniques failed in the detection of extra-pulmonary samples. Nested PCR showed, after species-specific amplification, a sensitivity of 100% for M. avium and 85% for M. tuberculosis. For extra-pulmonary smear-negative samples, only Nested PCR detected M. tuberculosis and all cases were confirmed clinically. Nested PCR, in which two-step amplification reactions are performed, can identify the two most important mycobacteria in human pathology quickly and directly from clinical spicimens

Complications and visual outcome of sclerally fixed posterior chamber intraocular lenses

Hundred eyes of 97 patients were operated for determining complications and visual outcome of Sclerally Fixed Posterior Chamber Intraocular Lenses at Institute of Ophthalmology, Mayo Hospital, Lahore from January 2002 till December 2002. Those operated either had ICCE done previously, per-operated large rent in posterior capsules, dislocated lens and t raumatic subluxated cataractous Iens. Immediate complications were transient rise in IOP, corneal edema, striate keratopathy. Late complications noted had decentration of IOL [4%], Cystoid Macular edema 4%, suture erosion [2%] and lens tilt [1%]. 80% patients had Post-operative V/A of 6/6-6/12 and 20% had V/A 6/18- 6/60 as compared to Pre-Operative V/A of 56% in 6/6-6/12, 10% in 6/18-6/60 and 34% in 3/60-PL+ ve. Encouraging results favour this procedure

Effect of Balance Exercise on Selected Kinematic Gait Variables in Patients with Knee Joint Osteoarthritis

The purpose of this study was to investigate the effect of balance exercise on some selected kinematic gait parameters in patients with knee joint osteoarthritis. Forty subjects (18 men and 22 women) participated in the study. They were divided into two groups: Group 1 (experimental) that was treated with balance exercises; thermal therapy and soft tissue massage; Group 2 (control); treated with thermal therapy and soft tissue massage without balance exercise. Gait analysis was done from footprints on a 900cm walking paper and functional balance was assessed using the Berg Balance Scale. The result showed a significant difference (P0.05) in all the gait parameters except step width and foot angle for group 1 and only walking velocity for group 2. The functional balance was significantly different in group 1 and not in group 2 comparing the pre and post treatment variables. It was concluded that balance exercise is effective in improving the functional ambulation of patient with knee osteoarthritis and should be an integral part of the patient rehabilitation

Dissection of the stylohyoid chain: a method of approach

La cadena estilohioídea está mereciendo, considerable atención debido a la gran incidencia del alargue de uno de sus elementos llamado proceso estiloide del hueso temporal, que caracteriza al Síndromede Eagle, llegando a alcanzar el 28 por ciento de la población. Nuestro trabajo tiene como objetivo describir un método de disección macroscópica para un abordaje de la cadena estilohioídea. Utilizando 15 regiones del cuello de cadáveres humanos, de sexo masculino se obtuvieron 30 cadenas estilohioídeas a través del método de disección macroscópica, observándose que el método de acceso por etapas, a partir de ambas extremidades de la cadena, es el que ofrece menor riesgo de lesión del ligamento estiloihíodeo preservándose, de esta manera, la integridad de la cadena estilohioídea